serw-MX  [xml]  
 


    
 DeCS Categories

N03 Health Care Economics and Organizations .
N03.219 Economics .
N03.219.521 Financing, Organized .
N03.219.521.576 Insurance .
N03.219.521.576.343 Insurance, Health .
N03.219.521.576.343.800 Managed Care Programs .
N03.219.521.576.343.820 Managed Competition .
N04 Health Services Administration .
N04.590 Patient Care Management .
N04.590.374 Delivery of Health Care .
N04.590.374.410 Managed Care Programs .
 
 Terms
 Synonyms & Historicals
Documents
LILACS e MDL
 
Managed Care Programs .
Managed Care .
Care, Managed .
Managed Care Program .
Management, Insurance Case .
Program, Managed Care .
Programs, Managed Care .
Case Management, Insurance .
Insurance Case Management .
Managed Health Care Insurance Plans .
Health insurance plans intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as HEALTH MAINTENANCE ORGANIZATIONS and PREFERRED PROVIDER ORGANIZATIONS. .
1.00
9723840
 
Patient Care Management .
Care Management, Patient .
Management, Patient Care .
Generating, planning, organizing, and administering medical and nursing care and services for patients. .
0.63
 
Managed Competition .
Accountable Health Plan .
Health Plan, Accountable .
Plan, Accountable Health .
Plans, Accountable Health .
Accountable Health Plans .
Competition, Managed .
Health Plans, Accountable .
A strategy for purchasing health care in a manner which will obtain maximum value for the price for the purchasers of the health care and the recipients. The concept was developed primarily by Alain Enthoven of Stanford University and promulgated by the Jackson Hole Group. The strategy depends on sponsors for groups of the population to be insured. The sponsor, in some cases a health alliance, acts as an intermediary between the group and competing provider groups (accountable health plans). The competition is price-based among annual premiums for a defined, standardized benefit package. (From Slee and Slee, Health Care Reform Terms, 1993) .
0.60
7534